Alpha Ambulance Inc. specialized in providing non-emergency ambulance transportation services to Medicare beneficiaries in Southern California, mostly to and from dialysis treatments.
The company’s general manager admitted that between April 2010 and July 2012, he conspired with the owners of Alpha and the company’s training supervisor to bill Medicare for ambulance service for individuals that did not need to be transported by ambulance.
Also, the general manager instructed emergency medical technicians employed by Alpha to conceal the true medical condition of patients they were transporting by doctoring paperwork and creating phony reasons for the transportation services.
Altered patient records
In early 2012, Medicare notified Alpha that they would be subject to a Medicare audit. In response, the general manager said that he and his co-conspirators altered patient documentation to illegally justify the ambulance transportation service.
He specifically admitted that he and the others used light tracing tables to trace over original documents and create fake patient records for submission to Medicare. They then shredded the original patient documents.
The general manager and his cohorts submitted $5,522,079 in fraudulent claims to Medicare, and Medicare paid $1,338,413 on those claims.
The general manager was approached by law enforcement officers and asked to cooperate with the investigation into Alpha. He proceeded to tell the owners of Alpha the names of the law enforcement officers who were doing the investigating and the questions they were asking. He later denied to the investigators that he had disclosed that information to the Alpha owners.
Entered a guilty plea
The general manager, Wesley Harlan Kingsbury, 34, of Bloomington, California, pleaded guilty to the charges against him and was sentenced to 78 months in prison. He was also ordered to pay $1,338,413 in restitution.
The owners of Alpha, Alex Kapri and Aleksey Muratov, and the training supervisor, Danielle Medina, also pleaded guilty to health care fraud. They were sentenced to 75 months, 108 months, and 30 months in prison, respectively.
The case was brought as part of the Medicare Fraud Strike Force, which is now operating in nine cities across the country. It has charged about 2,000 defendants who have collectively billed the Medicare program for more than $6 billion.